Abstract Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global pandemic that has affected millions of people worldwide. This study aims to bridge the knowledge gap between acute and chronic symptoms, vaccination impact, and associated factors in patients across different low-income countries. Methods: The study included 2,445 participants aged 18 years and older, testing positive for COVID-19. Data collection involved screening for medical histories, testing records, symptomatology, and persistent symptoms. Validated instruments, including the DePaul Symptom Questionnaire (DSQ-2) and Patient Health Questionnaire-9 (PHQ-9), were used. We applied a self-supervised and unsupervised deep neural network to extract features from the questionnaire. Gradient boosted machines (GMB) model was used to build a risk calculator for chronic fatigue, depression, and prolonged COVID-19 symptoms. The best-performing models were implemented in a shiny app and deployed online at: [https//ahmedshaheen.shinyapps.io/shaheen-covid-19/]. Also, there is an offline version of the application that can be downloaded: [link]. Findings: Out of the study cohort, 69.5% of the patients had symptoms lasting longer than 2 weeks. The most frequent symptoms were loss of smell 46.8%, dry cough (40.1%), loss of taste (37.8%), headaches (37.2%), and sore throat (28.9%). The patients also reported high rates of depression (47.7%), chronic fatigue (6.5%), and infection after vaccination (24.2%). Factors associated with chronic fatigue syndrome included sex, age, and smoking. Vaccinated individuals demonstrated lower odds of experiencing prolonged COVID-19 symptoms, chronic fatigue syndrome, and depression. The predictive models achieved a high area under the receiver operating characteristic curve (AUC) scores of 0.87, 0.82, and 0.74, respectively. Interpretation: The results provide insights into the consequences of COVID-19 and a predictive tool to understand factors influencing depression, chronic fatigue syndrome, and prolonged COVID-19 symptoms. The study reveals variables affecting these outcomes and the interplay between pre-existing conditions, treatments, and the duration of symptoms post-recovery.
Tuberculosis during pregnancy is associated with increased complications. The wide range of presentations among patients with extrapulmonary tuberculosis can make diagnosis and treatment difficult.We present the case of a patient with Mycobacterium tuberculosis pericarditis presenting in pregnancy with recurrent pericardial effusions. The diagnosis of active tuberculosis was made and treatment initiated after a positive interferon-gamma release assay and granulomatous pericardial pathology despite negative tuberculin skin testing. Culture of pericardial tissue obtained by pericardectomy confirmed the diagnosis 1 month after initiation of treatment.This case report demonstrates the use of interferon-gamma release assay in diagnosing tuberculosis among high-risk pregnant patients. Although limited by expense and minimal experience in pregnancy, these assays may be useful to screen for tuberculosis in high-risk pregnant populations.
To investigate the postpartum morbidity and postpartum management of febrile morbidity associated with advanced HIV infection.A case control study of HIV infected women at a tertiary care center during January 2000-June 2005 was performed. Postpartum morbidity was defined as endometritis, blood transfusion, wound complication, readmission, infectious morbidity, or unexpected surgery.Women in Group 1 had AIDS (N=33), Group 2 were relatively immunocompetent HIV infected women (N=115), and Group 3 were uninfected women (N=152). Group 1 was more likely to have a postpartum morbidity (32.3 versus 19.3 and 13.2%, P=.03) and to have postpartum imaging 18.8 versus 7.9 and 2.6%, P=.002. After controlling for potential confounders, cesarean delivery (OR 6.2, 95% CI 2.1-505.5) but not advanced HIV disease was associated with an increased risk of postpartum morbidity.Cesarean delivery and not advanced HIV disease increases the risk of postpartum morbidity in women with AIDS.
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